As is common, not all of the interview could make it into print. So I’m sharing a few additional thoughts here from Kaplan about the transition that he said has the hospital system now putting patients first.

How it started:

“It really began in the year 2000. We were coming off a couple of disappointing years in terms of our economic performance. The Institute of Medicine report had come out in 1999, the first Institute of Medicine report which began to detail that patients were being harmed in hospitals across the United States. We began to realize that health care quality, as good as we were - and as proud as I was, and all of us were at Virginia Mason - that it was not as good as it could be. We created a new strategic plan that was designed under the guidance of our health system board, which are community leaders from Boeing and other companies around the region, actually around the United States.

"The new plan helped us get clarity about who was our customer. You know, everyone in health care says 'the patient,' but if that were really so, our processes would be designed around the patient. Well, we came to realize, back over 12 years ago now, that our processes in the industry and at Virginia Mason were designed around us, the doctors, the nurses, the care givers. And we need to get clearer about how we design our processes around the patient; we need to develop a shared vision, which was actually to become the quality leader, not just in Seattle, but anywhere. That’s what we aspired to do."

Next steps:

“I, as a new CEO, began to look at leading health care organizations around the United States. I went personally to the Mayo Clinic, to the Harvard Hospitals, Massachusetts General, the University of Michigan, where I went to medical school, Stanford, University of Washington – and found out that nobody had a management method in health care. And then, serendipitously, we heard what Boeing was doing right here in our back yard. And Boeing in the preceding seven years had taken the construction of a 737 airplane from 22 days to 11 days. And did it in a shorter period of time, faster, made it higher quality, safer and made it at lower cost by employing the Toyota production system - what they call the Boeing production system.

Off to Japan:

"In the summer of 2002 we took our entire leadership team to Japan. And we came home convinced that this was the management system that could take us where we needed to go. And so, today, we’ve really affirmed that. We’ve learned so much more about what it takes. It’s not just saying, 'We’re going to read a few books and we’re going to do this.' It really has required the changing of the culture, deep training of our people. Leading as leaders in very different ways than we were leading before. And as I mentioned, it’s exciting seeing this take hold in the industry now."

And on what it means to avoid waste:

“The keys are creating flow, so there’s continuous movement, meaning if you’re waiting as a patient, or if you’re waiting as a physician, or a nurse – that’s waste. And there’s actually waste of waiting, there’s waste of inventory, supplies. You know, big store rooms with inventory you don’t need and we spend lots of money on.

"Wastes of movement, or transportation. We actually measure staff walking distance. We can take miles off of a nurse’s walking distance every day by changing the way work is designed. There’s so many examples of the way facilities are designed, so you actually bring all the services to the patient, as opposed to the patient (going) on a scavenger hunt across city blocks to get their needs met.”